The Tohoku journal of experimental medicine
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Tohoku J. Exp. Med. · Feb 2022
Review Case ReportsAnti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Developing Pancreatic Lesion and Diabetes Mellitus: A Case Report and Review of the Literature.
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) affects small blood vessels and causes severe systemic organ injury commonly affecting the lungs and kidney. However, gastrointestinal, especially pancreatic, lesions are rare. We report the case of a 67-year-old Japanese man diagnosed with myeloperoxidase (MPO) AAV who developed pancreatic lesions and diabetes mellitus. ⋯ Furthermore, blood glucose levels improved despite treatment with glucocorticoids. These findings suggest that AAV-related pancreatic lesions worsened glycemic control. However, glucocorticoid therapy improved vasculitis and pancreatic lesions, which resulted in improved glycemic control.
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Tohoku J. Exp. Med. · Feb 2022
Case ReportsImmunohistopathological Analysis of Extramedullary Hematopoiesis and Angiogenesis of Spleen in a Case of Primary Myelofibrosis with Huge Splenomegaly.
Although splenomegaly is one of the important signs of primary myelofibrosis, the differential diagnosis varies from malignant disorders to benign disorders, including malignant lymphoma and sarcoidosis. The patient was a 67-year-old male who developed anemia and huge splenomegaly. The laboratory findings include human T-cell leukemia virus type 1 (HTLV-1) antibody, elevated soluble interleukin-2 receptor, hypocellular bone marrow, and uptake in the spleen on positron emission tomography/computed tomography scan. ⋯ Splenectomy reduces blood transfusion requirements after surgery. The patient was carefully followed-up without further treatments. Thus, primary myelofibrosis is the crucial differential diagnosis of huge splenomegaly.
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Tohoku J. Exp. Med. · Feb 2022
Case ReportsTotal Hip Joint Replacement in a Patient with Colchicine-Resistant Familial Mediterranean Fever under Canakinumab Treatment.
Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by recurrent episodes of fever and serositis. Periodic febrile attack can be managed with biologic medication in colchicine-resistant FMF patients, however, no reports or guidelines exist regarding the postoperative management of elective joint surgery in these patients. Although it is not clear how FMF attacks are triggered, they may be precipitated by stress including anesthesia or surgery. ⋯ Discontinuation of canakinumab 3 weeks before surgery and resumption 6 weeks after led to favorable outcome without complications. This case addresses the differential management concerning stopping and restating of canakinumab in the perioperative setting in contrast to the other biologics such as tumor necrosis factor-α (TNF-α) or interleukin-6 (IL-6) blocking agents. This case report suggests that canakinumab may represent a safe and effective therapy for the colchicine-resistant FMF, even in the patients requiring THR therapy.
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Tohoku J. Exp. Med. · Feb 2022
Case ReportsLung Rest with Femoro-Femoral Veno-Venous Extracorporeal Membrane Oxygenation for COVID-19 Severe Pneumonia with Pneumomediastinum.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sometimes causes severe coronavirus disease 2019 (COVID-19) pneumonia. Here, we report the case of a 35-year-old man with obesity who showed severe respiratory failure from SARS-CoV-2 infection. Immediate high-resolution computed tomography (HRCT) of the chest after endotracheal intubation revealed a significant pneumomediastinum with diffuse ground-glass opacity and consolidation. ⋯ We gradually tapered off ECMO and employed a pressure-control mode. He was extubated on day 11. To our knowledge, this is the first reported patient who showed complete pneumomediastinum recovery from COVID-19 pneumonia with ECMO.
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Tohoku J. Exp. Med. · Feb 2022
Yippee Like 1 Suppresses Glioma Progression and Serves as a Novel Prognostic Factor.
Glioma is the most common tumor of central nervous system in adults with poor prognosis. Yippee Like 1 (YPEL1) is a newly discovered protein that plays contradictory roles in pancreatic cancer and colon cancer. Here we initially explored the expression, clinical significance, and function of YPEL1 in glioma. ⋯ Finally, overexpression of YPEL1 was performed in U87 and U373 cell lines to further validate its tumor-related functions, followed by proliferation, invasion, and subcutaneous mice xenografts assays. In vitro and in vivo data demonstrated that overexpressing YPEL1 can remarkably prevent glioma cell proliferation and invasion. Taken together, our data revealed that low YPEL1 expression was significantly correlated with poor overall survival of glioma patients and may play anti-tumor effects.